|
Smear gram stain
|
$52.82 |
$52.82 |
$52.82 |
$57.85
|
|
Smear nasal eosinophil
|
$19.89 |
$19.89 |
$19.89 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$54.77 |
$54.77 |
$54.77 |
$64.35
|
|
Smear wet mount
|
$52.49 |
$52.49 |
$52.49 |
$68.63
|
|
Snrpn/ube3a gene
|
$114.10 |
$114.10 |
$114.10 |
$228.80
|
|
Sock wool above knee
|
$244.50 |
$244.50 |
$244.50 |
$158.68
|
|
Sodium 24 hour urine
|
$68.14 |
$68.14 |
$68.14 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$51.51 |
$51.51 |
$51.51 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$51.51 |
$51.51 |
$51.51 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$51.51 |
$51.51 |
$51.51 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$53.79 |
$53.79 |
$53.79 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$128.77 |
$128.77 |
$128.77 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$76.61 |
$76.61 |
$76.61 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$360.89 |
$360.89 |
$360.89 |
$195.48
|
|
Somatosensory testing
|
$259.17 |
$259.17 |
$259.17 |
$583.80
|
|
Specific gravity body fluid
|
$36.52 |
$36.52 |
$36.52 |
$23.63
|
|
Speech evaluation complex
|
$519.65 |
$519.65 |
$519.65 |
$527.06
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$347.52 |
$347.52 |
$347.52 |
$559.96
|
|
Splint finger fold over sm
|
$109.21 |
$109.21 |
$109.21 |
$84.00
|
|
Splint finger frog med
|
$16.30 |
$16.30 |
$16.30 |
$27.95
|
|
Splint func pos polyflex ii med
|
$48.90 |
$48.90 |
$48.90 |
$52.22
|
|
Splint rstrc wrst/cmc right med
|
$109.21 |
$109.21 |
$109.21 |
$101.18
|
|
Split blood or products
|
$31.63 |
$31.63 |
$31.63 |
$148.98
|
|
Stent axios caut enh 15x10mm electrocaut
|
$46,885.32 |
$46,885.32 |
$46,885.32 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$914.43 |
$914.43 |
$914.43 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$29,113.43 |
$29,113.43 |
$29,113.43 |
$18,714.49
|
|
Strep a ag ia
|
$20.22 |
$20.22 |
$20.22 |
$75.40
|
|
Strep b dna amp probe
|
$44.01 |
$44.01 |
$44.01 |
$139.20
|
|
Streptomycin injection
|
$75.96 |
$75.96 |
$75.96 |
$138.30
|
|
Streptozocin injection
|
$1,412.89 |
$1,412.89 |
$1,412.89 |
$943.23
|
|
Stress test pulmonary
|
$198.86 |
$198.86 |
$198.86 |
$327.20
|
|
Stress tte complete
|
$1,749.32 |
$1,749.32 |
$1,749.32 |
$1,964.95
|
|
Str markers specimen anal
|
$200.82 |
$200.82 |
$200.82 |
$835.28
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$57.38 |
$57.38 |
$57.38 |
$49.13
|
|
Sugars single quant
|
$12.39 |
$12.39 |
$12.39 |
$52.47
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$94.22 |
$94.22 |
$94.22 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$286.56 |
$286.56 |
$286.56 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$143.44 |
$143.44 |
$143.44 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$92.59 |
$92.59 |
$92.59 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$108.24 |
$108.24 |
$108.24 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$122.25 |
$122.25 |
$122.25 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$156.81 |
$156.81 |
$156.81 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$169.20 |
$169.20 |
$169.20 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$294.71 |
$294.71 |
$294.71 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$83.46 |
$83.46 |
$83.46 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$27.39 |
$27.39 |
$27.39 |
$34.48
|
|
Susceptibility mic per plate
|
$127.00 |
$127.00 |
$127.00 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$14.64 |
$14.64 |
$14.64 |
$48.30
|
|
Svc venogram s&i
|
$751.43 |
$751.43 |
$751.43 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$56.73 |
$56.73 |
$56.73 |
$44.85
|
|
System cardiomems hosp electronics
|
$38,748.36 |
$38,748.36 |
$38,748.36 |
$41,639.82
|
|
System pacing micra av
|
$24,060.43 |
$24,060.43 |
$24,060.43 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$16,433.66 |
$16,433.66 |
$16,433.66 |
$10,980.00
|
|
System sealant biosentry tract
|
$702.53 |
$702.53 |
$702.53 |
$900.00
|
|
T3 (triiodothyronine) free
|
$94.54 |
$94.54 |
$94.54 |
$89.82
|
|
T3 (triiodothyronine) total
|
$114.10 |
$114.10 |
$114.10 |
$94.90
|
|
T4 (thyroxine) free
|
$56.08 |
$56.08 |
$56.08 |
$81.60
|
|
T4 (thyroxine) total
|
$84.11 |
$84.11 |
$84.11 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$7.83 |
$7.83 |
$7.83 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$607.67 |
$607.67 |
$607.67 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$13.37 |
$13.37 |
$13.37 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$847.60 |
$847.60 |
$847.60 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,339.21 |
$1,339.21 |
$1,339.21 |
$3,385.00
|
|
Target gsa panel organ neop
|
$982.60 |
$982.60 |
$982.60 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,547.53 |
$1,547.53 |
$1,547.53 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$130.08 |
$130.08 |
$130.08 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$70.09 |
$70.09 |
$70.09 |
$166.46
|
|
Tc-99m bicisate
|
$382.08 |
$382.08 |
$382.08 |
$1,969.45
|
|
Tc-99m diag per dose
|
$25.11 |
$25.11 |
$25.11 |
$279.95
|
|
Tc-99m exame autol wbc diag per dose
|
$1,206.53 |
$1,206.53 |
$1,206.53 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$511.82 |
$511.82 |
$511.82 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$75.96 |
$75.96 |
$75.96 |
$323.01
|
|
Tc-99m maa
|
$27.71 |
$27.71 |
$27.71 |
$312.06
|
|
Tc-99m mebrofenin
|
$41.41 |
$41.41 |
$41.41 |
$169.53
|
|
Tc-99m medronate
|
$98.46 |
$98.46 |
$98.46 |
$122.46
|
|
Tc-99m mertiatide
|
$41.08 |
$41.08 |
$41.08 |
$757.25
|
|
Tc-99m oxidronate
|
$32.60 |
$32.60 |
$32.60 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$39.78 |
$39.78 |
$39.78 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$67.49 |
$67.49 |
$67.49 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$7.18 |
$7.18 |
$7.18 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$41.08 |
$41.08 |
$41.08 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$293.73 |
$293.73 |
$293.73 |
$221.60
|
|
Tc-99m sulfur colloid
|
$152.57 |
$152.57 |
$152.57 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$261.46 |
$261.46 |
$261.46 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$625.27 |
$625.27 |
$625.27 |
$930.54
|
|
Tcd emboli detect without inj
|
$119.97 |
$119.97 |
$119.97 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$7.34 |
$7.34 |
$7.34 |
$186.00
|
|
T cells absolute cd 4 count
|
$9.78 |
$9.78 |
$9.78 |
$120.25
|
|
T cells total count
|
$9.54 |
$9.54 |
$9.54 |
$124.11
|
|
Telavancin injection
|
$2,247.12 |
$2,247.12 |
$2,247.12 |
$1,216.45
|
|
Telehealth original site facility fee
|
$30.32 |
$30.32 |
$30.32 |
$60.80
|
|
Temozolomide
|
$1,358.12 |
$1,358.12 |
$1,358.12 |
$374.66
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$5,848.77 |
$5,848.77 |
$5,848.77 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$29,845.30 |
$29,845.30 |
$29,845.30 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$73.03 |
$73.03 |
$73.03 |
$46.10
|
|
Testicular imaging w/vasc flow
|
$487.37 |
$487.37 |
$487.37 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$37.82 |
$37.82 |
$37.82 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$812.72 |
$812.72 |
$812.72 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,527.64 |
$1,527.64 |
$1,527.64 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$112.15 |
$112.15 |
$112.15 |
$108.00
|